Sep 2020 - Foresight Newsletter

Sep 2020 - Foresight Newsletter

FORE SIGHT

NSLHD SAFETY AND QUALITY NEWSLETTER

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The Northern Sydney Local Health District Clinical Governance Unit is excited to bring you the first issue of Foresight. Foresight is a monthly newsletter providing information on upcoming activities, programs and initiatives within the district that aims to ultimately improve the safety of our patients and the quality of our care.

If you would like to provide feedback or suggestions for future issues, please complete our survey

IN THIS ISSUE :

Aboriginal and Torres Strait Islander Cultural Engagement World Sepsis Day Dying to Know Day What’s New in Falls Prevention? NSLHD Frailty Initiative EIDO resources Accreditation Assessment Update

Clinical Governance Standard

Earlier this year, the Ministry of Health’s Centre for Aboriginal Health requested all local health districts complete an Aboriginal and Torres Strait Islander Cultural Engagement Self-Assessment. Additionally, reports to inform monitoring of cultural engagement will be shared with the Centre for Aboriginal Health annually. This important initiative aligns with several requirements expressed within the National Safety and Quality Health Service (NSQHS) Standards. Staff from all levels across the organisation have been invited to complete the self-assessment and an action plan to address identified gaps. Nurse Unit Managers and senior managers at Royal North Shore Hospital and Ryde Hospital recently participated in presentations held by Paul Weir (Operations Manager, Aboriginal Health) and Annette Penney (NSQHS Accreditation Manager). The presentations focused on the self-assessment requirements and how the National Standards relate to Aboriginal and Torres Strait Islander health. These presentations generated much discussion and awareness of Aboriginal and Torres Strait Islander health issues. Paul and Kuibuz (Gillian) Adidi also recently presented a successful webinar on ‘Stereotyping of Aboriginal and Torres Strait Islander’ people. Thank you to everyone who participated in the presentations and for your ongoing support with this important initiative. We look forward to seeing results from the self-assessments and action plans. ABORIGINAL AND TORRES STRAIT ISLANDER CULTURAL ENGAGEMENT

Look out for and join in the next Aboriginal Health Service webinar. Watch the video ‘ Asking the Question’ to understand the importance of identification of consumers and clients of Aboriginal and Torres Strait Islander origin. Complete the ‘Asking the Question’ online training Ensure your services are welcoming to Aboriginal and Torres Strait Islander people. Refer to the NSLHD Aboriginal and Torres Strait Islanders Health Service Plan 2017 – 2022 and Companion Document; and the NSQHS Standards User Guide Aboriginal and Torres Strait Islander Health. How can I support this initiative?

Care Culture Compliance Learning from excel lence and experience

NSLHD CLINICAL GOVERNANCE

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Recognising and Responding to Acute Deterioration Standard

WORLD SEPSIS DAY

Did you know that sepsis claims 11 million lives globally each year with more than 8500 of those occurring in Australia. This World Sepsis Day (13 September) we are urging all health workers to be alert for signs and symptoms of sepsis, even in COVID-19 patients, and ask 'Could it be sepsis?' If you think it might be, your patient requires escalation to a senior clinician, rapid assessment, treatment and source control.

Getting involved in World Sepsis Day

There are many ways you can get involved in raising sepsis awareness, being mindful it is COVID safe by following guidance for infection prevention and control.

A number of promotional ideas and resources are available on the Clinical Excellence Commission's World Sepsis Day webpage. Some suggested activities are listed below – most can be adapted or undertaken virtually.

Arrange a sepsis morning tea or lunch Hold a Sepsis Cake ‘n’ Bake competition Dress up as a ‘sepsis hero’ and share the photos Put sepsis screensavers on your computers Hold education sessions and include sepsis in Grand Rounds (where applicable) Share sepsis videos and posters

Please share your Wor ld Sepsis Day photos and/or stor ies wi th the Cl inical

Excel lence Commission (CEC): CEC-sepsis@heal th.nsw.gov.au

Comprehensive Care Standard

DYING TO KNOW DAY

Dying to Know Day (D2KDay) aims to bring to light conversations and community actions around death, dying and bereavement. Held on 8 August, D2KDay is a national day of conversation and action. Since 2013 thousands of people have taken part with discussions, workshops and events.

D2KDay promotes the development of Death Literacy - the practical know-how needed for end of life planning. It is important NSLHD take a public health approach to these conversations.

Death, dying and bereavement are social experiences best addressed through initiatives that involve and build a compassionate community. Meaningful value based end of life planning occurs at any age and regardless of our health status.

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Comprehensive Care Standard

WHAT’S NEW IN FALLS PREVENTION?

Project Spotlight NSLHD FRAILTY INITIATIVE The Northern Sydney Local Health District (NSLHD) Frailty Initiative is a partnership between NSLHD and the Sydney North Health Network (SNHN) with consumer advocacy to identify and address frailty in the older population by aligning screening and management of frailty in both primary care and in hospital. The Initiative promotes awareness of frailty and how it can be reversed in a patient centred care model. Now embedded into every day practice at Hospital Kur- ring-gai Hospital, the initiative uses a validated tool to identify frailty in admitted patients. Screening triggers referrals as indicated to physiotherapy for resistance training and enhanced mobility, pharmacy to address polypharmacy, and dietetics to manage unintended weight loss, along with comprehensive geriatric assessment from the beginning of the admission. On discharge, a frailty management letter is sent to the patient’s GP to support them integrate recommendations in their ongoing health management plan. With the development of a Sydney North Frailty HealthPathway to standardise evidence based care, frail older people are

Reduction in falls risk screening time to within 8 hours instead of 24 hours to bring us in line with other NSW Hospitals. Use of the Adult eFRAMP falls management plan in eMR to replace the paper-based version. Safety Huddles to pro-actively manage any risks to patient safety. Meaningful Intentional Rounding to regularly check on the needs of high-risk patients at scheduled times. Post-Fall Huddles. Conversations with patients, carers and staff following a fall or near-fall to ascertain potential causes to reduce further falls. ‘Give it a Go’ mobility enhancement and standardised mobility terminology . Encourages nursing staff to use clinical judgement criteria to allow selected patients to mobilise without allied health assessment in order to reduce deconditioning. Falls occur in all ages of admitted and non-admitted patients and can be life-threatening particularly for those aged over 70 years. This year, NSLHD in partnership with the Clinical Excellence Commission, we are rolling out the best initiatives from the Leading Better Value Care Falls collaborative. These include: How will this be coming to you? Look out for your facility Falls Prevention Champions from Allied Health and Nursing. They will be providing training, support and resources around these initiatives.

encouraged to be linked to community based physiotherapy, dietetics and pharmacy review.

The FRAIL scale on the Electronic Medical Record is available across the district in both inpatient and outpatient settings.

The Frailty Initiative is the winner of this year’s NSLHD Quality & Improvement - Delivering Integrated Care Award, and a nominated entry at this year’s NSW Health Awards. Check out this video showcasing their project.

Dr Linda Xu, Geriatrician

How do I start an improvement project? Find out more on the Clinical Governance Quality Improvement Intranet site, Innovation Hub or contact your local Quality Advisor.

The district Acute/Sub-Acute Falls Prevention Committee continues to work in conjunction with all our facilities, clinicians, patients and carers to reduce falls risk. For further information contact NSLHD Falls Prevention Coordinator: [email protected]

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Partnering with Consumers Standard

PATIENT INFORMATION RESOURCES Patient information for various medical and surgical procedures, including its risks and benefits, are available via the EIDO Healthcare download centre. These documents are designed to facilitate discussion between clinicians and patients (and, if applicable, their carers and substitute decision-makers); and supports patients to make informed consent. You can view and download almost 400 procedure-specific documents in various accessible formats and translations.

Access EIDO resources from the Intranet home page Quick Links or via the EIDO Download Centre (Username: NSLHD, Password: consent12)

ACCREDITATION ASSESSMENT UPDATE

In March 2020, the Australian Commission on Safety and Quality in Health Care (ACSQHC) put a temporary hold on accreditation assessments, in response to the COVID-19 pandemic. As yet NSLHD has no confirmed dates for Royal North Shore, Ryde and Hornsby Ku-ring-gai hospitals and Mental Health Drug and Alcohol accreditation assessments. Meanwhile, preparation continues to ensure all hospitals and services are ready once revised dates are announced.

Please contact your facility or service Clinical Governance or Safety and Quality Unit if you have any queries about the accreditation process.

SAFETY ALERTS

Clinical Governance Standard

New , u p d a t e d a n d r e c e n t l y p u b l i s h e d

SN:008 / 20 - Illicit supply of counterfeit alprazolam (updated) - Reissued 9 September 2020

Safety Alert RED - Requires immediate attention and action Safety Notice AMBER - Requires risk assessment at the district level Safety Information GREEN - Ensuring that lessons learned from state-wide, national or international sources are shared actively across NSW health system

For more information, contact: [email protected]

POLICIES, PROCEDURES AND GUIDELINES New , u p d a t e d a n d r e c e n t l y p u b l i s h e d d i s t r i c t w i d e PPGs

Clinical Governance Standard

GE2020_013 - Patients with chronic kidney disease post parathyroidectomy, management of GE2020_014 - Identifying and Caring for Adult In-Patients in the last days of life in NSLHD Acute Hospitals GE2016_009 - Prevention of contrast-induced acute kidney injury (CI-AKI) in Adults - NSLHD PR2009_400 - Maintenance Operations - Personal Protective Equipment (PPE) - NSLHD PR2009_358 - Emergency Department Admission Acceptance - NSLHD GE2013_015 - Hydrotherapy and Other Swimming Pools Use and Maintenance of- NSLHD GE2020_016 - Administration of Intravenous (IV) Furosemide in the Community Setting PR2020_025 - Safe Sleeping Practices in Maternity Services - NSLHD PR2009_347 - Hot Works Permit Procedure - Maintenance Operations NSLHD PR2013_096 - Colistin Dosing Guidelines: Use in Multi-drug Resistant Gram- Negative organisms- NSLHD GE2020_015 - Monitoring patients with prolonged disorders of consciousness post severe brain injury - NSLHD GE2015_011 - Cognitive Impairment – Clinical Practice Guidelines for Care of Adults in NSLHD Hospitals

Check out the NSLHD Policies Procedures intranet site for more information.